医学
多发性骨髓瘤
血栓形成
血栓性
静脉血栓形成
不确定意义的单克隆抗体病
血栓
下腔静脉
放射科
病理
外科
内科学
单克隆
单克隆抗体
抗体
免疫学
作者
Jolie Kun,Jonathan Hunter
出处
期刊:Case Reports
[BMJ]
日期:2024-06-01
卷期号:17 (6): e260061-e260061
标识
DOI:10.1136/bcr-2024-260061
摘要
A man in his 40s presented to the emergency department after 2 weeks of abdominal pain and bloating. Radiological investigations revealed multiple unusual sites of thrombosis, including large thrombi in his portal and mesenteric veins, and a left ventricular thrombus with resultant embolic infarcts to his spleen, kidneys, coronary arteries and brain. Standard causes of underlying thrombophilia were excluded. A serum protein electrophoresis and serum-free light chains, with subsequent bone marrow biopsy, lead to the diagnosis of smouldering multiple myeloma (sMM), albeit an unusual presentation with severe clinical sequelae. Although sMM is known to be associated with an increased risk of venous thromboembolism, it is not recognised to cause thrombosis in both venous and arterial vascular beds simultaneously. Physicians encountering patients with multiple thrombi in unusual vascular beds without clear aetiology should consider an underlying monoclonal gammopathy in their list of differentials.
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